Presented to the Clinical Instructor of

The Notre Dame of Tacurong College

College of Nursing
ACUTE GASTROENTERITIS with MODERATE DEHYDRATION
_________________________________________________
Mr. Richard DeoRoxAlave, RN
Clinical Instructor
In Partial Fulfillment of the Course
Requirements in
NURSING CARE MANAGEMENT 107 RLE

Submitted by:
BAI SANDRA M. SINAGANDAL
BSN 4 STUDENT

Date:

TABLE OF CONTENTS

I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
XV.
XVI.
XVII.
XVIII.
XIX.
XX.
XXI.
XXII.

Introduction
Objectives of the Study
Vital information
Family Background
History of Past Illness
History of Present Illness
Effects and Expectations
Genogram
Developmental Data
Physical Assessment
Textbook Discussion/ Anatomy & Physiology
Definition of Terms
Etiology/ Symptomatology
Pathophysiology
Doctors Order
Laboratory Results
List of Drugs
Drugs Study
List of Prioritized Problem
Nursing Care Plan
Prognosis
References
OBJECTIVES

General Objectives:
After 1 hour of reading the case, the readers will be able to gain
adequate knowledge on Acute Gastroenteritis (AGE) and enhance knowledge
and skills in dealing with patients having this kind of condition , hence
allowing listeners to apply their learning appropriately in clinical setting and
develop positive attitude in caring for patients with the same condition.

Specific Objectives:

After 1 hour of reading the case, the readers will be able to:

Discuss the brief summary of the introduction about the disease

involved.
Enumerate completely the general and specific objectives.
Identify correctly with important information regarding patients data
by presenting the following:
Vital Information
History of present and past Illness
Family Background
Effects and Expectations of illness to self and family
Genogram
Growth and Development Data

Discuss the result of Physical Assessment Cephaloucaudically.

Identify completely with Review of System.
Discuss comprehensive with complete diagnosed of the patient based

on textbook discussion.
Relate the Anatomy and Physiology of the systems involved in AGE.
Enumerate the predisposing and precipitating factors involved with the

diagnosis clearly.
Enumerate the etiology of AGE.
Discuss the pathophysiology of AGE.
Identify the laboratory test undergone by the patient and interpret the

result accurately.
Discuss the doctors order for patient wellness and rationalize properly.
Rationalize the drugs that the physicians ordered and discuss the
mechanisms of action, side and adverse effects, contraindication,

special precaution and drug interaction precisely.

Prioritized nursing diagnosis of patient and enumerate applicable

nursing interventions correctly.

Enumerate the references/bibliography precisely.

Acute Gastroenteritis
INTRODUCTION
This is a case of baby J, a 4 years old male patient of South Cotabato
Provincial Hospital. He was admitted last January 18, 2015 at 7:45am with
admitting diagnosis of Acute Gastroenteritis with moderate dehydration,
under the service of Dr. San.
Acute Gastroenteritis is inflammation of the gastrointestinal tract, involving
both the stomach and the small intestine and resulting in acute diarrhea.
The inflammation is caused most often by infection with certain viruses, less
often by bacteria or their toxins, parasites, or adverse reaction to something
in the diet or medication. At least 50% of cases of gastroenteritis as
foodborne illness are due to norovirus. Another 20% of cases, and the
majority of severe cases in children, are due to rotavirus. Other significant
viral agents include adenovirus and astrovirus.
Different species of bacteria can cause gastroenteritis, including Salmonella,
Shigella, Staphylococcus, Campylobacter jejuni, Clostridium, Escherichia coli,
Yersinia, and others. Each organism causes slightly different symptoms but
all result in diarrhea. Colitis, inflammation of the large intestine, may also be
present. Some types of acute gastroenteritis will not resolve without
antibiotic treatment, especially when bacteria or exposure to parasites are
the cause. Physicians may want to diagnose the cause by analyzing a stool
sample, when stomach symptoms remain problematic.

According to the World Health Organization (WHO) and UNICEF,

there are about two billion cases of diarrheal disease worldwide
every year, and 1.9 million children younger than 5 years of age
perish from diarrhea each year, mostly in developing countries.
This amounts to 18% of all the deaths of children under the age of

five and means that more than 5000 children are dying every day
as a result of diarrheal diseases. Of all child deaths from diarrhea,
78% occur in the African and South-East Asian regions. Each child
under 5 years of age experiences an average of three annual
episodes of acute diarrhea. Globally in this age group, acute
diarrhea is the second leading cause of death (after pneumonia),
and both the incidence and the risk of mortality from diarrheal
diseases are greatest among children in this age group,
particularly during infancy thereafter, rates decline
incrementally. Other direct consequences of diarrhea in children
include growth faltering, malnutrition, and impaired cognitive
development in resource-limited countries.
In the Philippine Health Statistic, gastroenteritis range as number 10 in the
ten leading causes of infant mortality, with the rate of 0.5 and percentage of
4.1 cases in the Philippines by the year 2004 this was updated last February
12, 2008.

Significance of the study:

This study will enable the students to understand better about acute
gastroenteritis and will explain the different risk factors for developing the
disease, including consumption of improperly prepared foods or
contaminated water and travel or residence in areas of poor sanitation Since
we are client-centered, we really should consider our patients comfort and
this study will give the students sufficient knowledge that will help them to
plan and implement nursing care plans that will satisfy patients needs.

PATIENTS DATA
Vital Information

Patients Name:

Baby J

Age:

2 years old

Sex:

Male

Birth Date:

October 25, 2012

Birth Place:

Koronadal City, South Cotabato

Address:

Sitio Mani, topland (Bo.7) Koronadal South Cotabato

Occupation:

none

Tribe:

Ilonggo

Citizenship:

Filipino

Religion:

Roman Catholic

Civil Status:

Single

Body weight:

25.5 kg

Educational Attainment: none

Name of Institution:

South Cotabato Provincial Hospital

Date and Time of Admission: January 18, 2015 @ 7:45 pm

Chief Compliant: ga tae-tae siya kag suka as verbalize by

the Pt.s mother
Admitting Diagnosis:
Moderate Dehydration

Acute Gastroenteritis with

Attending Physician:

Dr. San

Parents Name:
1. Mrs. K
2. Mr. L

27
32

housewife
Tricycle Driver

Sibling:
1. Kaye
2. Pt. J
Source of Information:
1. Mrs. K
2. Pt.s Chart

5
2

Student
none

Family background
Pt. J was born on October 25, 2012 at Koronadal City, South Cotabato. He is
an affiliate of Roman Catholic. He lived in Sitio Mani, Topland Bo.7, koronadal
city South Cotabato. He is a Second son of the family. According to his
mother, only Mr. L is the one who worked for the family because no one will
take care of their kids except Mrs. K. Mrs. K stated that baby J completed his
immunizations such as BCG1, OPV3, DPT3, Hepa-b3, MMR1. He was
breastfeed until he is 1 year old, and now he is already bottle feed. Based on
their diet,Mrs. L cook food such as fish and vegetable, they rarely eat meat
because according to Mrs. L it is too expensive. She also stated that Pt. baby
J is so hard to make him eat his food that is why he is under weight for his
age.
According to Mrs. L they do not have any hereditary diseases. Baby Js
grandparents are both alive.
Their house was made of half cement and half kalakat, it has one room,
kitchen and a living room. The comfort room is outside their house. Their

water source is nawasa and poso. They have pets in the house, 1 dog and 2
cats.
Based on their finances, Mr. L has a 250 per day for his boundary because
the tricycle he drive is not owned by Mr. L. So, he gets 7,500 per month plus
1,400 pesos a month by the government subsidy which is the 4 Ps
(pantawid pamilyang Pilipino program).
According to Mrs.L, whenever they got sick they do not directly consult the
doctor, instead they just go to health center and ask for a medicine such as,
Paracetamol for fever, Biogesic for head ache, neozep for flu and lagundi
capsule for cough.

History of Past Illness

According to Mrs. L having a diarrhea is not the first time of baby J, when he
was 7 months old he also experience diarrhea. But 6 months prior to
admission Pt. baby J doesnt experience any type of disease.
History of Present Illness
On the day prior to admission Pt. baby J experienced 3days of diarrhea,
watery yellow stool, He also experience vomiting. He also stated that he is
having stomach pain. He was rushed to hospital at South Cotabato Provincial
Hospital. He was admitted to the hospital around 7:45 pm with the admitting
diagnosis of acute gastroenteritis with moderate dehydration under the
service of Dr. San, MD.

Effect and Expectations of Illness to Self and Family

To Self:
No verbalization.
To family:
Family verbalized that they are worried about the patients condition
and expect that the patient will recovered soon so that the expenses will be
lessen. According to Mrs. L due to his sons illness he loses his weights. The
family expects that the patient will recover soon.

DEVELOPMENTAL DATA
Developmental task theory of Robert Havighurst
A developmental task is a task which arises at or about a certain period in the life
of an individual. Havighurst has identified six major age periods:
infancy and early childhood (0-5 years), middle childhood (6-12 years),
adolescence (13-18years), early adulthood (19-29 years), middle
adulthood (30-60 years), and later maturity (61+)
Based on Havighurst s Theory, The patient developmental theory is in Infancy and
early chidhood
Theory
Task
Justification
Remarks
Robert
Havighurs
t
(infancy
and early
childhood)

Learning to walk

Learning to take
solid foods
Learning to talk

According to Mrs. L, his son baby J

learned to walk when he was 9
m0nth old.
Accondong to Mrs. L, baby J started
to eat solid food when he is 9 month
old.
According to Mrs. L baby J learns to
talk and can say a different words
when he was 1 year and 4 months

Learn to control
the elimination
of body waste

According to Mrs. L baby J learn to

control his body waste when he is 1
years and 6 months, whenever he
wants to pee he calls his mother
right away.

Learning sex
differences and
sexual modesty

According to Mrs. L baby J knows

that he is a boy and his sister is a
girl.

Forming

According to Mrs. L baby J can

differenciate his parents by calling

Achieved

Achieved
Achieved

Achieved

Achieved

Achieved

concepts and
learning
language to
describe
social and
physical
reality.
Getting ready to
read

them as mama and papa.

According to Mrs. L baby J loves to

check the book of his sister and he
can describe the picture on it.

Achieved

PSYCHOSOCIAL THEORY
Erik Erikson
He envisions life as a sequenceof level of achievement. Each stage
signals a task that must be achieved. The resolution of the task can be
complete, partial or unsuccessfully.
Erikson believes that the greater the task achievement, the healthier
the personality of the person failure to achieve the task influences the ability
of the person to achieve the next task. This developmental task can be
viewed as a series of crisis and unsuccessful resolution of this crisis is
damaging to the ego. After attaining ones stage, the person may fall back
and need to approach it again.
Theory

Task

Justification

Remarks

Erik Erikson
(will)

Autonomy vs. shame

and doubt

According to Mrs. L sometimes

baby J wanted to do things on its
own like eating foods, bathing,
playing his toys, choosing clothes
he wears and etc

Achieved

PHYSICAL ASSESSMENT
Date and time:
January 11,2015
7:45 PM
General Appearance:
The patient is a young male, with IVF D5LR 160 gtts/hr hooked at right
basillic vein, patent and infusing well. Patient is conscious, hair is not wellfixed, The patient wears striped sando and wears diaper.
Vital signs:
T- 37 C
RR- 20 cpm
PR-72 bpm

Head/Hair/Scalp:
Inspection: Head is proportional to the body and skull is rounded and
symmetrical, no dandruff and lice noted, hair is evenly distributed, gray in
color with dry texture.
Palpation: No tenderness and masses noted.
Face:
The face is symmetrical; skin is brown in complexion and has poor skin
turgor.

Eyes:
Eyes are symmetrical, eyebrows are black in color. Yellowish discharges
noted. Pupils are equal in size and reacts to light. Eye opening is good.
Conjunctiva is pinkish in color and sclera is well lubricated.
Nose:
Inspection: The external nose is symmetrical, align at the midline,
nasogastric tube noted inserted through the right nostril, mucosa is moist,
nasal septum is intact, no lesions and nose deformities noted.
Palpation: There is no tenderness noted.
Ears:
Inspection:

Ears are symmetrical, normal in size with equal color to the

body complexion, no lesions noted, small amount of dirt accumulates at the

external ear, earwax noted, auricle has no deformities, pinna recoils when
folded.
Palpation: No tenderness and nodules noted.
Mouth and Lips:
Inspection: Lips are pale in with dry and flaky texture, no presence of
stomatitis, no lesions noted, the tongue is pinkish in color with white spots.
Incomplete set of teeth and yellow-orange color of the teeth is noted. Gums
and mucosa is light pink and no lesion noted. Tonsils are not inflamed; uvula
is bell in shape, pinkish in color, and at the midline.
Neck:
Inspection: Jugular veins are not inflamed and no stiffness noted.
Palpation: Lymph nodes at the neck are not palpable.
Breast:
Inspection: Brown areola and nipple noted, areola are equal in size.
Palpation: No tenderness and masses noted.
Lungs:
Auscultation: Breathing pattern is normal and no irregular rhythm noted.
Heart:
Auscultation: No abnormal sound noted.
Abdomen:
Inspection: No scars noted upon inspection. No lesion noted.
Auscultation: Gurgling sound noted. 7 gurgling sound/min.
Palpation: No tenderness noted, no masses noted.

Extremities:
Inspection: Extremities are proportionate to the trunk; skin is brown in
complexion, symmetrical on both upper and lower extremities. Immobility
noted on the right leg and arms. No withdrawal even on evoked pain
stimulus.
Skin:
Inspection: Skin is dry and flaky, no lesions

noted. Skin has poor skin

turgor.
Palpation: No masses and tenderness noted. Cool to touch.
Nails Inspection: Nails are dirty, and pinkish in color. Capillary refills after 3
seconds.

Anatomy and Physiology

THE DIGESTIVE SYSTEM

The digestive system is a group of organs working together to convert food

into energy and basic nutrients to feed the entire body. Food passes through
a long tube inside the body known as the alimentary canal or the
gastrointestinal tract (GI tract). The alimentary canal is made up of the oral
cavity, pharynx, esophagus, stomach, small intestines, and large intestines.
In addition to the alimentary canal, there are several important accessory
organs that help your body to digest food
but do not have food pass through them. Accessory organs of the digestive
system include the teeth, tongue, salivary glands, liver, gallbladder, and
pancreas. To achieve the goal of providing energy and nutrients to the body,
six major functions take place in the digestive system:
-Ingestion
-Secretion
-Mixing and movement
-Digestion
-Absorption
-Excretion

Digestive System Anatomy

Mouth
Food begins its journey through the digestive system in the mouth, also known as
theoral cavity. Inside the mouth are many accessory organs that aid in the digestion
of foodthe tongue, teeth, and salivary glands. Teeth chop food into small pieces,
which are moistened by saliva before the tongue and other muscles push the food into
the pharynx.

Teeth. The teeth are 32 small, hard organs found along the anterior and lateral
edges of the mouth. Each tooth is made of a bone-like substance called dentin and
covered in a layer of enamelthe hardest substance in the body. Teeth are living
organs and contain blood vessels and nerves under the dentin in a soft region known as
the pulp. The teeth are designed for cutting and grinding food into smaller pieces.

Tongue. The tongue is located on the inferior portion of the mouth just posterior
and medial to the teeth. It is a small organ made up of several pairs
of muscles covered in a thin, bumpy, skin-like layer. The outside of the tongue contains
many rough papillae for gripping food as it is moved by the tongues muscles. The taste
buds on the surface of the tongue detect taste molecules in food and connect to nerves
in the tongue to send taste information to the brain. The tongue also helps to push food
toward the posterior part of the mouth for swallowing.

Salivary Glands. Surrounding the mouth are 3 sets of salivary glands. The
salivary glands are accessory organs that produce a watery secretion known as saliva.
Saliva helps to moisten food and begins the digestion of carbohydrates. The body also
uses saliva to lubricate food as it passes through the mouth, pharynx, and esophagus.

Pharynx
The pharynx, or throat, is a funnel-shaped tube connected to the posterior end of the
mouth. The pharynx is responsible for the passing of masses of chewed food from the
mouth to the esophagus. The pharynx also plays an important role in the respiratory
system, as air from the nasal cavity passes through the pharynx on its way to the
larynx and eventually the lungs. Because the pharynx serves two different functions, it
contains a flap of tissue known as the epiglottis that acts as a switch to route food to
the esophagus and air to the larynx.
Esophagus
The esophagus is a muscular tube connecting the pharynx to the stomach that is part
of the upper gastrointestinal tract. It carries swallowed masses of chewed food
along its length. At the inferior end of the esophagus is a muscular ring called the
loweresophageal sphincter or cardiac sphincter. The function of this sphincter is to close
of the end of the esophagus and trap food in the stomach.
Stomach
The stomach is a muscular sac that is located on the left side of the abdominal cavity,

just inferior to the diaphragm. In an average person, the stomach is about the size of
their two fists placed next to each other. This major organ acts as a storage tank for
food so that the body has time to digest large meals properly. The stomach also
contains hydrochloric acid and digestive enzymes that continue the digestion of food
that began in the mouth.

Small Intestine
The small intestine is a long, thin tube about 1 inch in diameter and about 10 feet
long that is part of the lower gastrointestinal tract. It is located just inferior to the
stomach and takes up most of the space in the abdominal cavity. The entire small
intestine is coiled like a hose and the inside surface is full of many ridges and folds.
These folds are used to maximize the digestion of food and absorption of nutrients. By
the time food leaves the small intestine, around 90% of all nutrients have been
extracted from the food that entered it.
Liver and Gallbladder
The liver is a roughly triangular accessory organ of the digestive system located to the
right of the stomach, just inferior to the diaphragm and superior to the small intestine.
The liver weighs about 3 pounds and is the second largest organ in the body. The liver
has many different functions in the body, but the main function of the liver in digestion
is the production of bile and its secretion into the small intestine. The gallbladder is a
small, pear-shaped organ located just posterior to the liver. The gallbladder is used to
store and recycle excess bile from the small intestine so that it can be reused for the
digestion of subsequent meals.
Pancreas
The pancreas is a large gland located just inferior and posterior to the stomach. It is
about 6 inches long and shaped like short, lumpy snake with its head connected to
the duodenum and its tail pointing to the left wall of the abdominal cavity. The
pancreas secretes digestive enzymes into the small intestine to complete the chemical
digestion of foods.

Large Intestine
The large intestine is a long, thick tube about 2 inches in diameter and about 5 feet
long. It is located just inferior to the stomach and wraps around the superior and lateral
border of the small intestine. The large intestine absorbs water and contains many
symbiotic bacteria that aid in the breaking down of wastes to extract some small
amounts of nutrients. Feces in the large intestine exit the body through the anal canal.

Digestive System Physiology

The digestive system is responsible for taking whole foods and turning them into energy
and nutrients to allow the body to function, grow, and repair itself. The six primary
processes of the digestive system include:
1.
2.
3.
4.
5.
6.

Ingestion of food
Secretion of fluids and digestive enzymes
Mixing and movement of food and wastes through the body
Digestion of food into smaller pieces
Absorption of nutrients
Excretion of wastes

Ingestion
The first function of the digestive system is ingestion, or the intake of food. The mouth
is responsible for this function, as it is the orifice through which all food enters the
body. The mouth and stomach are also responsible for the storage of food as it is
waiting to be digested. This storage capacity allows the body to eat only a few times
each day and to ingest more food than it can process at one time.
Secretion
In the course of a day, the digestive system secretes around 7 liters of fluids. These
fluids include saliva, mucus, hydrochloric acid, enzymes, and bile. Saliva moistens dry
food and contains salivary amylase, a digestive enzyme that begins the digestion of
carbohydrates. Mucus serves as a protective barrier and lubricant inside of the GI tract.
Hydrochloric acid helps to digest food chemically and protects the body by killing
bacteria present in our food. Enzymes are like tiny biochemical machines that
disassemble large macromolecules like proteins, carbohydrates, and lipids into their
smaller components. Finally, bile is used to emulsify large masses of lipids into tiny
globules for easy digestion.
Mixing and Movement
The digestive system uses 3 main processes to move and mix food:

Swallowing. Swallowing is the process of using smooth and skeletal muscles in

the mouth, tongue, and pharynx to push food out of the mouth, through the pharynx,
and into the esophagus.

Peristalsis. Peristalsis is a muscular wave that travels the length of the GI tract,
moving partially digested food a short distance down the tract. It takes many waves of
peristalsis for food to travel from the esophagus, through the stomach and intestines,
and reach the end of the GI tract.

Segmentation. Segmentation occurs only in the small intestine as short

segments of intestine contract like hands squeezing a toothpaste tube. Segmentation
helps to increase the absorption of nutrients by mixing food and increasing its contact
with the walls of the intestine.
Digestion
Digestion is the process of turning large pieces of food into its component chemicals.
Mechanical digestion is the physical breakdown of large pieces of food into smaller
pieces. This mode of digestion begins with the chewing of food by the teeth and is
continued through the muscular mixing of food by the stomach and intestines. Bile
produced by the liver is also used to mechanically break fats into smaller globules.
While food is being mechanically digested it is also being chemically digested as larger
and more complex molecules are being broken down into smaller molecules that are
easier to absorb. Chemical digestion begins in the mouth with salivary amylase in saliva
splitting complex carbohydrates into simple carbohydrates. The enzymes and acid in the
stomach continue chemical digestion, but the bulk of chemical digestion takes place in
the small intestine thanks to the action of the pancreas. The pancreas secretes an
incredibly strong digestive cocktail known as pancreatic juice, which is capable of
digesting lipids, carbohydrates, proteins and nucleic acids. By the time food has left
the duodenum, it has been reduced to its chemical building blocksfatty acids, amino
acids, monosaccharides, and nucleotides.
Absorption
Once food has been reduced to its building blocks, it is ready for the body to absorb.
Absorption begins in the stomach with simple molecules like water and alcohol being
absorbed directly into the bloodstream. Most absorption takes place in the walls of the
small intestine, which are densely folded to maximize the surface area in contact with
digested food. Small blood and lymphatic vessels in the intestinal wall pick up the
molecules and carry them to the rest of the body. The large intestine is also involved in
the absorption of water and vitamins B and K before feces leave the body.
Excretion
The final function of the digestive system is the excretion of waste in a process known
as defecation. Defecation removes indigestible substances from the body so that they
do not accumulate inside the gut. The timing of defecation is controlled voluntarily bthe
conscious part of the brain, but must be accomplished on a regular basis to prevent a
backup of indigestible materials.

http://www.innerbody.com/image/digeov.html

TEXTBOOK DISCCUSSION
Acute Gastroenteritis
Gastroenteritis or infectious diarrhea is a medical condition from inflammation ("-itis") of
the gastrointestinal tract that involves both the stomach ("gastro"-) and the small
intestine ("entero"-). It causes some combination of diarrhea, vomiting, and abdominal pain
and cramping.[1]Dehydration may occur as a result. Gastroenteritis has been referred to
as gastro, stomach bug, and stomach virus. Although unrelated toinfluenza, it has also
been called stomach flu and gastric flu.
http://en.wikipedia.org/wiki/Gastroenteritis

Acute gastroenteritis is a common cause of morbidity and mortality worldwide. Conservative estimates
put diarrhea in the top 5 causes of deaths worldwide, with most occurring in young children in
nonindustrialized countries. In industrialized countries, diarrheal diseases are a significant cause for
morbidity across all age groups. Etiologies include bacteria, viruses, parasites, toxins, and drugs.
Viruses are responsible for a significant percentage of cases affecting patients of all ages. Viral
gastroenteritis ranges from a self-limited watery diarrheal illness (usually < 1 wk) associated with
symptoms of nausea, vomiting, anorexia, malaise, or fever, to severe dehydration resulting in
hospitalization or even death.

The clinician encounters acute viral gastroenteritis in 3 settings. The first is sporadic gastroenteritis in
infants, which most frequently is caused by rotavirus.[1] The second is epidemic gastroenteritis, which
occurs either in semiclosed communities (eg, families, institutions, ships, vacation spots) or as a result
of classic food-borne or water-borne pathogens. [2] Most of these infections are caused by caliciviruses.
The third is sporadic acute gastroenteritis of adults, which most likely is caused by caliciviruses,
rotaviruses, astroviruses, or adenoviruses.
http://emedicine.medscape.com/article/176515-overview

Acute gastroenteritis is an extremely common illness among infants

and children worldwide. According to the Centers for Disease Control
and Prevention (CDC), acute diarrhea among children in the United
States accounts for more than 1.5 million outpatient visits, 200,000
hospitalizations, and approximately 300 deaths per year. In developing
countries, diarrhea is a common cause of mortality among children
younger than age 5 years, with an estimated 2 million deaths each

year. American children younger than 5 years have an average of two

episodes of gastroenteritis per year, leading to 2 million to 3 million
office visits and 10% of all pediatric hospital admissions. Furthermore,
approximately one third of all hospitalizations for diarrhea in children
younger than 5 years are due to rotavirus, with an associated direct
cost of $250 million annually.
http://pedsinreview.aappublications.org/content/33/11/487.full

ETIOLOGY
Precipitating factor
Factor

Rationale

Age
(2 y/o)

According to the World Health

Organization (WHO) and UNICEF,
there are about two billion cases of
diarrheal disease worldwide every
year, and 1.9 million children
younger than 5 years of age perish
from diarrhea each year, mostly in
developing countries.

Gender
(male)

Remarks

Present

Predisposing factor
Factor

Rationale

Remarks

Environment

Hygiene

stress

According to World Health

Organization of all child deaths
from diarrhea, 78% occur in the
African and South-East Asian
regions. Each child under 5 years
of age experiences an average of
three annual episodes of acute
diarrhea.

Present

According to Mrs. L, baby J is fund of

playing outside their house with the other
kids in their compound

IV. LABORATORY EXAMINATION

URINALYSIS
Urinalysis- is the physical, chemical & microscopic examinations of urine. It
involves a number of tests to detect & measure various compounds that pass
through the urine.
Date:1/12/15
ACTUAL
NORMAL
INTERPRETATI
ANALYSIS
PARAMETER FINDINGS FINDINGS
ON
S
Color
Light
Pale yellow
normal
Yellow
Transparency
Slightly
Clear to
normal
Turbid
slightly
turbid
Specific
1.020
1.015normal
Gravity
1.025

Albumin
Sugar
pH
Pus cells
RBC
Epithelial
Cells
Bacteria

Mucus
Threads
Amorphous
Materials

negative
negative
6.0
2-3/hpf
0-2/hpf
Few

negative
negative
7.35-7.45
2-3 hpf
2-4 hpf
few

normal
normal
decreased
normal
normal
normal

Occassional

Absent

abnormal

Few

Few

normal

Moderate

Few

abnormal

acidic

Normally absent,
if present it
indicates
infection.

Too much
crystals in the
urine is an
indication of
having kidney
stones.

Fecalysis
Date: 1/12/15
PARAMETER
S
Color
Consistency
Pus Cells
RBC

ACTUAL
FINDING
S
Yellowish
Soft
0-3/hpf

NORMAL
FINDING
S
Yellowish
Soft
0

INTERPRETATIO
N

0-1/hpf

0-5/hpf

normal

normal
normal
abnormal

ANALYSIS

Invasion of
microorganisms.

PROGNOSIS
Criteria

Good

Fair

Poor

Justification

Onset of
Illness

It is Pt. jays
first
hospitalization
due to Acute
gastroenteritis.

Duration of
Illness

Pt. Jay got this

disease for the
first time.

The patients
hygiene is fair

Hygiene

because he can
take a bath and
do his activity
of daily living.

Pt. jays diet is

good because
Diet

he eats a lot and

drink.
At this age
Age

they dont mind

their food they
eat as long as it
as the taste is
good.

Computation:
Good: 2/5x 100% = 40%
Fair: 3/5 x 100% = 60%
Bad: 0/5 x 100% = 0%
Total: 100%

The interpretation of the Prognosis is Fair, because the pt. still having a
diarrhea with moderate dehydration.
Bibliography:
https://www.google.com.ph/?gfe_rd=cr&ei=xo_aVP7MGaK8QeuzIHoCA#safe=off&q=predisposing+factors+of+gastroenteritis
+on+adolescents
2011 LIPPINCOTTS NURSING DRUG HANDBOOK
MEDICAL SURGICAL NURSING BY UDAN
WWW.GOOGLE.COM
WWW.MEDSCAPE.COM/ACUTEGASTROENTERITIS